During this session, the therapist reviews the patient's efforts to monitor interruption of his/her well-being. Techniques to intervene with such interruptions are reviewed and reinforced with the patient. Therapist and patient also review the six key areas of well-being—environmental mastery, personal growth, purpose in life, autonomy, self-acceptance, and positive relations with others. They focus on the areas that are most relevant to the patient's current issues. Once the most relevant areas are selected, time is spent in session identifying and practicing techniques that facilitate the patient moving toward the optimal level of functioning in each of these areas. Because this is the next to last session, therapist and patient spend some time discussing progress achieved thus far in treatment and strategies to prevent relapse.


Well-Being Therapy Techniques. The therapist reviews patient entries in the Well-Being Diary. At this point in treatment, the patient is expected to be able to identify readily moments of well-being (regardless of length), to be aware of interruptions in feelings of well-being (cognitions), and to utilize CT techniques to address these interruptions. If the patient completes this entire process with particular ease, only a brief review of examples from the patient's diary is necessary. However, if the patient seems to be struggling with one or more phases of this process, then the therapist reviews several examples—both fictitious and from the patient's life. It is important to emphasize to the patient that these skills help to prevent relapse and enhance feelings of well-being.

Review of Six Areas of Well-Being and Identification of Dimensions Relevant to Patient's Life. The therapist reviews the six dimensions of well-being and the corresponding impaired and optimal levels of functioning for each. The patient is asked to review each dimension consecutively and to indicate where it falls on the impaired-optimal continuum. This insession review, along with information gleaned from previous reviews of the patient's Well-Being Diary, greatly inform the therapist of the patient's most relevant dimensions. Strategies (used in session and at home) to move the patient toward optimal functioning in relevant dimensions encompass previously reviewed CT techniques. Examples are behavioral techniques (e.g., increasing assertive behavior and scheduling pleasant activities) and cognitive ones (e.g., use of the Dysfunctional Thought Record and the assessment diary, and the therapist challenging the patient's automatic negative thoughts in session). The overall goal here is to identify clearly those well-being dimensions that need work and to reinforce techniques that effectively increase the likelihood of optimal functioning.

Review of Progress and Preparation for Termination. It is important for the therapist to review progress the patient has made up to this point in therapy, and to remind the patient that the next session is the last of this treatment. Points to review include CT techniques utilized by the patient in and out of session that produced relief from distress, dimensions of well-being and how to prevent interruptions of these feelings, and the importance of the patient's ability to conduct "self-therapy."

Homework Assignment. The patient is asked to write a review of what he/she have learned in therapy. The therapist provides some guidance for this assignment by asking that the patient focus on the key elements to coping with distress, his/her particular problem areas, and the tactics he/she can use to enhance well-being. In addition, the patient is asked again to keep a Well-Being Diary for the 2-week interim period, adding a column of observer's interpretations.

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